Allergy Coding Alert
Reader Question: Time as the Determining Factor
Question: Is there a CPT code for the time taken to teach patients how to self-administer allergy shots or to provide them with other allergy education and training?
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Answer: Physicians can bill a new or established patient visit based on time if more than 50 percent of the time with the patient was for counseling or coordination of care, which seems to be the case here. The E/M section of the CPT 2001 Manual includes many E/M codes (new and established patient visits, consults, admissions and subse-quent inpatient care services) with a time component that can be determined when counseling or coordination of care dominates the visit. For example, if the physician spends 15 minutes total with the patient, and more than half of that time was spent counseling or coordinating care, 99213 could be billed without regard to the usual components of a visit, namely, history, exam or medical decision-making. When time is the determining factor, start and stop times should be clearly documented.
- Published on 2001-09-01
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